unbundling charges

[Kyrshamarks, BSN, RN]

Children's Hospital of Milwaukee has started to unbundle nursing charges from the room charge. They are now billing insurance companies for nursing hours.

In case you are interested in knowing how much you are worth to the hospital per hour.. if you work in the picu, you are worth 193.00 per hour per patient. That means with an average load of 2 patients, the hospital is billing 286.00 per hour.

[amoLucia]

Oops. $386 per hour?

Regardless, I think it's a good idea, but are they actually being reimbursed? Or is it just something on paper. And I'd be curious how it is that they actually determined what makes up the $193.

[Kyrshamarks, BSN, RN]

They are getting reimbursed for these charges. I help a friends company that does medical bill review for small ppo and ipo's. I review many high dollar cases on a prn basis and see these bills and the payments made . They are getting the money.

As for my math error, opps...lol me bad. Late night at work.

[scottaprn]

At what rate are they being reimbursed? Do they bill for nursing procedures as well ?

[Kyrshamarks, BSN, RN]

The reimbursement rate depends on the company paying. Some just pay it and others fight the charge, which we help do, but the average discount is only 38% off the amount. The procedures are covered under the hourly rate.

Regardless of what nursing hours are billed, nor at what rate, the nursing wages are not likely to be impacted.

In my engineering roles, our hours were billed to clients at a burdened rate of about 10:1 and yet we still went through many years of wage freezes and 1% increases... the only significant increases I ever got over about 20 years of engineering were when I changed jobs or got promoted.

[Spangle Brown]

At that rate, it seems RN's could argue that there is enough in the hr rate to add some cna back up.

[dt70]

Regardless of what nursing hours are billed, nor at what rate, the nursing wages are not likely to be impacted.

In my engineering roles, our hours were billed to clients at a burdened rate of about 10:1 and yet we still went through many years of wage freezes and 1% increases... the only significant increases I ever got over about 20 years of engineering were when I changed jobs or got promoted.

I felt cheated at 3:1.